Which SMMC LTC Plans Serve Miami? Comparing Your Managed Care Options

When your loved one is approved for SMMC LTC in Miami, they’re enrolled in a managed care plan that administers their home care benefits. The plan you choose — or get assigned to —affects how quickly services start, how responsive the case management team is, and whether CareChoice is in the provider network.

The Major Plans in Miami-Dade

Humana Long-Term Care is one of the largest SMMC LTC plans in South Florida. Humana brings the resources of a national health insurer and has an established long-term care case management infrastructure in the Miami market. Their provider network in Miami-Dade is broad.

Sunshine Health Long-Term Care is part of Centene Corporation and serves a significant Medicaid population across Florida. Sunshine Health has invested in community health programs in Miami and maintains a strong network of home care providers.

Additional plans may serve Miami-Dade depending on current state contracts. The Florida Medicaid enrollment broker (1-877-711-3662) can provide the current list of available plans in your area.

What to Consider When Choosing

In our experience establishing CareChoice in Miami, plan choice matters in three ways.

Case manager responsiveness.  The case manager is your family’s primary point of contact within the plan. They develop the care plan, authorize services, and handle issues. Ask how quickly a case manager is assigned after enrollment and what the average caseload is.

Provider network.  Confirm that CareChoice is in the plan’s provider network. If we’re not in-network for a specific plan, your family may need to choose a different plan or request an out-of-network exception.

Authorization speed.  How quickly does the plan move from enrollment to care plan to active services? Some plans have more streamlined processes than others. In a market as demand-heavy as Miami, efficiency matters.

Can You Change Plans?

Yes. If you’re unhappy with your SMMC LTC plan, you can request a change during the annual open enrollment period or in certain circumstances outside of it. Contact the Florida Medicaid enrollment broker for guidance on plan changes.

Contact CareChoice →Miami team

Written by Shamere Dunswell, Community Relations Manager | CareChoice